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Review Article

Sophisticated regulation of micturition: review of basic neurourology

원문정보

Chung Lyul Lee, Jaegeun Lee, Jong Mok Park, Hyun Seok Na, Ju Hyun Shin, Yong Gil Na, Khae Hawn Kim

한국운동재활학회 JER Vol.17 No.5 2021.10 pp.295-307
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초록

영어

The neurological regulation of the lower urinary tract can be viewed separately from the perspective of sensory neurons and motor neurons. First, in the receptors of the bladder and urethra of sensory nerves, sensations are transmitted through the periaqueductal gray matter of the midbrain to the cerebral cortex, and the cerebrum goes through the process of decision-making. Motor neurons are divided into upper motor neurons (UMNs) and lower motor neurons (LMNs). UMNs coordinate storage and micturition in the brain stem so that synergic voiding can occur. LMNs facilitate muscle contractions in the spinal cord. The muscles involved in urinary storage and micturition are innervated by the somatic branches of sympathetic, parasympathetic, and peripheral nerves. Sympathetic nerves are responsible for contractions of urethral smooth muscles, while parasympathetic nerves originate from S2–S4 and are in charge of contractions of the bladder muscle. Somatic nerves originate from the motor neurons in Onuf’s nucleus, which is a specific part of somatic nerves. In this review, we will investigate the structures of the nervous systems related to the lower urinary tract and the regulatory system of innervation for the urinary storage and micturition and discuss the clinical significance and future prospects of neurourological research.

목차

Abstract
INTRODUCTION
THE PERIPHERAL NERVOUS SYSTEM OF THE LOWER URINARY TRACT
Parasympathetic nerves
Sympathetic nerves
Somatic nerves
Afferent innervation
Interactions between the urothelium and afferent nerves
THE CENTRAL NERVOUS SYSTEM OF THE LOWER URINARY TRACT
Spinal cord
Brain stem: pons and PAG
The cerebrum: regulatory mechanisms identified through human brain imaging research
PHYSIOLOGY OF URINARY CONTINENCE AND MICTURITION REFLEX
The reflex circuit that regulates urinary storage
The reflex circuit that regulates micturition
THE CENTRAL PATHWAY THAT REGULATES THE MICTURITION REFLEX
CLINICAL SIGNIFICANCE
DIRECTIONS OF NEUROUROLOGICAL RESEARCH
NEUROUROLOGICAL RESEARCH PERSPECTIVES
CONFLICT OF INTEREST
ACKNOWLEDGMENTS
REFERENCES

저자정보

  • Chung Lyul Lee Department of Urology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
  • Jaegeun Lee Department of Urology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
  • Jong Mok Park Department of Urology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
  • Hyun Seok Na Department of Urology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
  • Ju Hyun Shin Department of Urology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
  • Yong Gil Na Department of Urology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
  • Khae Hawn Kim Department of Urology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea

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